Spadaccini M, Iannone A, Maselli R, et al. - The‌ ‌study‌ ‌found‌ ‌higher‌ ‌detection‌ ‌rates‌ ‌of‌ ‌colorectal‌ ‌neoplasia‌ ‌with‌ ‌ computer-aided‌ ‌detection‌ ‌(CADe)‌ ‌than‌ ‌with‌ ‌other‌ ‌techniques‌ ‌such‌ ‌as‌ ‌ chromoendoscopy‌ ‌or‌ ‌tools‌ ‌that‌ ‌increase‌ ‌mucosal‌ ‌visualization,‌ ‌supporting‌ ‌ wider‌ ‌incorporation‌ ‌of‌ ‌CADe‌ ‌strategies‌ ‌into‌ ‌community‌ ‌endoscopy‌ ‌services.‌ ‌

• Researchers‌ ‌enrolled‌ in ‌50‌ ‌randomized‌ ‌controlled‌ ‌trials‌ ‌including‌ ‌a‌ ‌total‌ ‌of‌ ‌ 34,445‌ ‌participants,‌ ‌in‌ ‌our‌ ‌main‌ ‌analysis‌ ‌(six‌ ‌trials‌ ‌of‌ ‌CADe,‌ ‌18‌ ‌of‌ ‌ chromoendoscopy,‌ ‌and‌ ‌26‌ ‌of‌ ‌increased‌ ‌mucosal‌ ‌visualization‌ ‌systems).‌ ‌

• In‌ ‌all‌ ‌ 50‌ ‌studies,‌ ‌high‌ ‌definition‌ ‌(HD)‌ ‌white-light‌ ‌endoscopy‌ ‌was‌ ‌the‌ ‌control‌ ‌ technique.‌ ‌

• The‌ ‌adenoma‌ ‌detection‌ ‌rate‌ ‌was‌ ‌7·4%‌ ‌higher‌ ‌with‌ ‌CADe‌ ‌(OR‌ ‌1·78‌ ‌ [95%‌ ‌CI‌ ‌1·44–2·18]),‌ ‌4·4%‌ ‌higher‌ ‌with‌ ‌chromoendoscopy‌ ‌(1·22‌ ‌[1·08–1·39]),‌ ‌ and‌ ‌4·1%‌ ‌higher‌ ‌with‌ ‌increased‌ ‌mucosal‌ ‌visualization‌ ‌systems‌ ‌(1·16‌ ‌ [1·04–1·28])‌ ‌in‌ ‌comparison‌ ‌with‌ ‌the‌ ‌control‌ ‌technique.‌

• CADe‌ ‌ranked‌ ‌as‌ ‌the‌ ‌ superior‌ ‌technique‌ ‌for‌ ‌adenoma‌ ‌detection‌ ‌(with‌ ‌moderate‌ ‌confidence‌ ‌in‌ ‌ hierarchical‌ ‌ranking);‌ ‌cross-comparisons‌ ‌of‌ ‌CADe‌ ‌with‌ ‌other‌ ‌imaging‌ ‌ techniques‌ ‌displayed‌ ‌a‌ ‌significant‌ ‌increase‌ ‌in‌ ‌the‌ ‌adenoma‌ ‌detection‌ ‌rate‌ ‌with‌ ‌ CADe‌ ‌vs‌ ‌increased‌ ‌mucosal‌ ‌visualization‌ ‌systems‌ ‌(OR‌ ‌1·54‌ ‌[95%‌ ‌CI‌ ‌ 1·22–1·94];‌ ‌low‌ ‌certainty‌ ‌of‌ the ‌evidence)‌ ‌and‌ ‌with‌ ‌CADe‌ ‌vs‌ ‌chromoendoscopy‌ ‌ (1·45‌ ‌[1·14–1·85];‌ ‌moderate‌ ‌certainty‌ ‌of‌ ‌the evidence).‌

• ‌When‌ ‌focusing‌ ‌on‌ ‌large‌ ‌ adenomas‌ ‌(≥10‌ ‌mm)‌ ‌researchers‌ ‌found‌ ‌a‌ ‌significant‌ ‌increase‌ ‌in‌ ‌the‌ ‌detection‌ ‌ of‌ ‌large‌ ‌adenomas‌ ‌only‌ ‌with‌ ‌CADe‌ ‌(OR‌ ‌1·69‌ ‌[95%‌ ‌CI‌ ‌1·10–2·60],‌ ‌moderate‌ ‌ certainty‌ ‌of‌ ‌the evidence)‌ ‌when‌ ‌matched‌ ‌with‌ ‌HD‌ ‌white-light‌ ‌endoscopy;‌ ‌CADe‌ ‌ ranked‌ ‌as‌ ‌the‌ ‌superior‌ ‌strategy‌ ‌for‌ ‌the detection‌ ‌of‌ ‌large‌ ‌adenomas.‌

• ‌Although‌ ‌no‌ ‌ significant‌ ‌increase‌ ‌in‌ ‌the‌ ‌sessile‌ ‌serrated‌ ‌lesion‌ ‌detection‌ ‌rate‌ ‌was‌ ‌shown,‌ ‌ CADe‌ ‌also‌ ‌appeared‌ ‌to‌ ‌be‌ ‌the‌ ‌superior‌ ‌strategy‌ ‌for‌ ‌detection‌ ‌of‌ ‌sessile‌ ‌serrated‌ ‌ lesions‌ ‌(with‌ moderate‌ ‌confidence‌ ‌in‌ ‌hierarchical‌ ‌ranking).‌ ‌

• There‌ ‌was‌ ‌no‌ ‌ a significant‌ ‌difference‌ ‌in‌ ‌withdrawal‌ ‌time‌ ‌for‌ ‌CADe‌ ‌compared‌ ‌with‌ ‌the‌ ‌other‌ ‌ techniques.‌ ‌